The fragility of evidence – suicide example

Workplace fatality data is an essential ingredient in benchmarking safety performance for business and government.  Suicide statistics are equally important in the social and public health context.

The editorial in the current issue of the Medical Journal of Australia has some interesting comments on how suicide statistics have been collected in Australia over the last decade.

“….a great deal of caution must be employed when interpreting trends in suicide in Australia during the past decade, particularly when making comparisons between jurisdictions (as these have been found to be differentially affected, as a result of differences in coronial processing times).  Unfortunately, it is likely that at least part of the apparent decline since about 2002 shown by ABS [Australian Bureau of Statistics] statistics and reported by various authors, including Large and Nielssen, is an artefact of increased misclassification of suicide deaths.”

The editorial goes on to say that changes have been introduced to provide more reliable data in the future but the editorial is important o remember when the Australian media and workplace and mental health lobby groups quote suicide statistics.

It makes one wonder, in a profession like safety that advocates making decisions based on evidence, just how reliant the evidence is on the collection of accurate statistics.

Kevin Jones

reservoir, victoria, australia
Categories community, death, evidence, government, OHS, research, safety, statistics, UncategorizedTags , , , ,

5 thoughts on “The fragility of evidence – suicide example”

  1. I had the privileged of sitting with Rosemary at an Injured Workers Stakeholders meeting yesterday (at Workcover SA) where, as part of the meeting, we were given a presentation by a Psychiatrist who I will not name on the matter of suicide, apparently his area of specialty.

    After 20 minutes or so, it was patently obvious that his understanding of the mechanisms of case management as it is applied in the day to day management of injured workers was woefully limited. His advice was reactive rather than proactive and showed a clear ignorance of the stresses affecting injured workers and their dependants and wider social group as a result of worker / case manager interaction.

    The current arms length management of longer term injured workers (12 months plus) by aggresive external agents is most unhelpful and in the main a primary contributor for a good number of suicides in the system. As Rosemary says, de stigmatising the issue would help.

    Behavioural standards of case managers is a very real problem and needs attention urgently in South Australia. As I understand it, legal action against individual case managers is being investigated relating to \”due care\” and other matters that contribute to the exacerbation of an injured workers injuries and or condition. This will be an interesting move to follow.

  2. It is my true hope that suicide is spoken about for all the people who have lost a loved one but more important I hope that suicide is spoken about so as those who start to feel that there is no other way forward for them seek help that is supportive and understanding.

    The emergency help lines do a wonderous task, they are trained to respond to suicide calls.
    However they lack in training in regard to the effects of WorkCover on the life of the injured worker.
    One injured worker called me at 4.13am one Sunday morning about a year back, the caller rang in hope that I would answer my phone.
    We talked as I dressed to meet him, all the time I was hoping that my mobile phone battery would hold. At 5am we sat having coffee at a truckstop.
    He told me that it was his intent to simply walk into the path of a B-double, he had calculated everything down to the very smallest detail.

    He told me that he had called an emergency help line, and all though the person on the other end of the line had been supportive, the only recommendation was that the injured worker call the case manager and discuss the issues that had driven him to the point of suicide.
    The emergency helper could not understand that it was the case manager who was creating the issues that were behind all the woes of the injured worker.

    There is much to be done, and much that is already being done, it is also time that the industry professionals stopped believing in their own studies and research and asked those of us at the coal face what it is that we know.

  3. For mine there can be no information gathered or statistics put into any graph until suicide is openly spoken about and the various workplace and WorkCover authorites acknowledge what we all know and that is that people for a multiple of reasons take their own lives. Until the veil of secrecy and shame is lifted in regard to loss of life via suicide all we will have is the constant talkfest with professional people making well researched and highly paid assumptions.

    Over the years I have been working as a Community Advocate within the South Australian WorkCover system, I have attended the funerals of those who have elected to take their own lives, I have held the hands and the broken hearts of loved ones left behind. I have spent many hours talking with injured workers who have been tempted or have tried to take their own lives, and I have to be honest during the darkest times of my own WorkCover claim I did attempt suicide myself.
    Yet never has any industry professional approached me to ask me what is it that I know or what are my thoughts.

    It is all well and good to be cautious when it comes to speaking about suicide and it is all well and good to compare the various jurisdictions, however the story remains the same regardless of caution or jurisdiction.
    Some one for what ever reason decided that life was too hard to live.

    Most people do not even understand that suicide is not about death, suicide is about ending what ever pain/frustration/dis-ease/torment that is so intensly focused that it appears there is nothing else other than suicide to end that pain/frustration/dis-ease/torment.
    Many years ago the mother of a young man who took his own life allowed me to read the daily planning diary of her son so as together we could attempt to make sense of what had happened.

    The daily diary was very detailed, right up to the day of the suicide, then there was a break of 5 days to the day of the funeral. The details included the type of coffin style and the colour of the lining, even the books that were to be buried with him, along with a thermos of sweet tea – a drink that this person had never liked.
    There was also the type of flowers to be placed on top of the coffin, the verses from selected pieces of poetry to be read.

    For 3 months there was nothing more in the diary.
    Then there was a \”re-starting\” of this young man\’s life, including the entry exam for attending a university.
    The books that were to be buried were the study books required for the pre-entry exam required for adult entry for the course.
    The rest of the diary was filled with study group information, possible new ways forward.
    Even a time set aside to sit with his \”old\” family and explain to them just what it was that they would want to know, however the words written in heavy red pen clearly indicated that there would be no discussion about the previous life, so the un-asked and unanswered questions of \”why\” would not be allowed.
    It was to my way of understanding that there would be no allowing of the \”old life\” into the \”new life\”.

    I return to stating that nothing will change until suicide is no longer a taboo subject.
    It is my belief that when suicide is no longer a silent subject the hold that suicide gains over the tormented and broken people will loosen.

    As for my own attempt, I just wanted to escape the horror of drug control for my physical pain and lift the haze in my mind created by the chemical imbalance.
    Nothing can ever remove the horror that I put my own family through throughout that time.
    Harder than that is the knowing that even today 13 years later, there are others being prescribed medication that will etch away the self-belief and respect of self until tha dance of suicide becomes the only dance that the drug filled person will be able to do.

    And still the professionals believe that they are the only ones who know what needs to be understood and spoken of openly and honestly .

    Caution and jurisdiction have no place at this table we have buried too many for lack of open courage and honesty.

  4. I found this to be a frustrating exercise in the the more mundane area of Back Injuries, which has been reclassified so many time it is nauseating.

    The question goes: What is the answer you are looking for? now design the statistical analysis to suit. Somewhat cynical I know, but nevertheless accurate in many cases.

    When the organisations that are best served by having honest and reliable statistics play \”spin games\” and have \”tricky\” labels to confuse the outcome, then we have serious dishonesty in the information provided to our legislators who we rely upon to look after the interests of their constituency.

    National standards should be in place to cover this in detail, otherwise any attempt at harmonisation is useless.

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